North Dakota State Telehealth Laws and Reimbursement Policies

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Information Provided ByCenter for Connected Health Policy

© Public Health Institute/ Center for
Connected Health Policy 2019: http://cchpca.org

North Dakota Medicaid

North Dakota
Medicaid Program: North Dakota M edicaid

Medicaid Program Administrator: North Dakota Dept. of Human Services

Regional Telehealth Resource Center:

Great Plains Telehealth Resource and Assistance Center
University of Minnesota/Institute for Health Informatics

330 Diehl Hall
505 Essex Street S.E.
Minneapolis, MN 55455

(888) 239-7092
www.gptrac.org

STATE LAW/REGULATIONS MEDICAID PROGRAM

Definition of telemedicine/telehealth

Telehealth:

Means the use of interactive audio, video or other telecommunications technology that is used by a health care provider or health care facility at a distant site to deliver health services at an originating site and that is delivered over a secure connection that complies with the requirements of state and federal laws.

Includes the use of electronic media for consultation relating to the health care diagnosis or treatment of a patient in real time or through the use of store and forward technology.

Does not include the use of audio only telephone, electronic mail, or facsimile transmissions.

Source: ND Code Sec. 26.1-36-09.15.

Stroke system of care task force

“Telemedicine services means the use of interactive audio, video, and other electronic media used for the purpose of diagnosis, consultation, or treatment of acute stroke.”

Source: ND House Bill 1323 (2015), ND Statute Sec. 23-43-05.

North Dakota uses federal definitions for “internet” and “practice of telemedicine” set in the Ryan Haight Online Pharmacy Consumer Protection Act of 2008.

Source: ND Century Code, Sec. 19-02.1-15.1.

“Telemedicine means the practice of medicine by a practitioner, other than a pharmacist, who is at a location remote from the patient, and is communicating with the patient, or health care professional who is treating the

Telemedicine is the use of interactive audio -video equipment to link practitioners and patients at different sites.

Source: Medicaid Medical Policy. North Dakota Department of

Human Services: Policy Number NDMP-2012-0007. Telemedicine Services. (Jan. 14, 2015) (Accessed Oct. 2017).

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

patient, using a telecommunications system.”

Source: Ryan Haight Online Pharmacy Consumer Protection Act
of 2008 [Pub. L. 110-425; 21 U.S.C. 802-803].

Physical Therapy:

“Telehealth” is the use of electronic communications to
provide and deliver a host of health-related information
and healthcare services, including, but not limited to
physical therapy related information and services, over
large and small distance. Telehealth encompasses a
variety of healthcare and health promotion activities,
including, but not limited to, education, advice,
reminders, interventions, and monitoring of

interventions.

Source: ND Admin. Code 61.5-01-02-01.

Live Video Reimbursement

North Dakota’s Worker Compensation Act provides reimbursement for live video.

Eligible services:

Office or other outpatient visits;

New evaluation visits and established management visits;

Individual psychotherapy visits; Pharmacologic management visits.

The patient must be present and participate in the appointment.

The professional fee is equal to comparable in-person services.

Source: ND Admin. Code 92-01-02-34.

North Dakota Medicaid will reimburse for live video services as long as the patient is present during the service. Actual visual contact (face-to-face) must be maintained between practitioner and patient.

Both originating-site and distant-site physicians may bill for services. There is no separate reimbursement for supplies.

There is reimbursement for long- distance charges required for out-of-network sites.

Source: ND Dept. of Human Svcs., General Information For Providers, Medicaid and Other Medical Assistance Programs, p. 129 (April 2012) (Accessed Oct. 2017).

Eligible services:

New and established Office and other outpatient E/M services

Psychiatric diagnostic evaluation

Individual psychotherapy

Pharmacologic management

Speech Therapy, individual

Initial inpatient telehealth consultation

Reimbursement is made only to the distant practitioner during the telemedicine session. No reimbursement is allowed to the originating site practitioner if he/she solely presents the patient to the distant site practitioner.

Requires an individual to be present during the telehealth service; and to ensure a connection has been established with the distant physician.

Out of state requests for telemedicine services require prior authorization.

Source: Medicaid Medical Policy. North Dakota Department of

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

Human Services: Policy Number NDMP-2012-0007. Telemedicine

Services. (Jan. 14, 2015) (Accessed Oct. 2017).
Indian Health Services
Reimbursement for telemedicine is on the same basis
as those provided for face-to-face contact.
Source: ND MMIS Web Portal. Indian Health Services. April 2015.
(Accessed Aug., 2016).

Store and Forward Reimbursement

No reference found. North Dakota Medicaid does not reimburse for store and
forward.
Source: ND Dept. of Human Svcs., General Information For
Providers, Medicaid and Other Medical Assistance Programs, p.
129 (April 2012) (accessed Oct. 2017).

Remote Patient Monitoring Reimbursement

No reference found. No reference found.

Email/Phone/FAX

Telehealth does not include audio-only telephone, No reference found for email.

electronic mail or facsimile transmission. No reimbursement for telephone.
Source: ND Code Sec. 26.1-36-09.15. No reference found for FAX.

Source: ND Dept. of Human Svcs., General Information For
Providers, Medicaid and Other Medical Assistance Programs, p.
126 (April 2012) (accessed Oct. 2017).

Online Prescribing

A valid prescription via e-prescribing means a No reference found.
prescription has been issued for a legitimate medical
purpose, in the usual course of professional practice, by
a practitioner who has first conducted an in-person
medical evaluation of the patient. An in-person medical
evaluation can include the referring practitioner having
performed the exam, in the case of telemedicine.
Source: ND Centennial Code, Sec. 19-02.1-15.1.

Consent

No reference found. No reference found.

Location

No reference found. The distant site must be a sufficient distance from the
originating site to provide services to patients who do
not have readily available access to such specialized
services allowed/reimbursed by ND Medicaid via
telemedicine.
Source: Medicaid Medical Policy. North Dakota Department of
Human Services: Policy Number NDMP-2012-0007. Telemedicine
Services. (Jan. 14, 2015) (Accessed Oct. 2017).

Cross-State Licensing

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STATE LAW/REGULATIONS MEDICAID PROGRAM

The ND Medical Board may engage in reciprocal No reference found.
licensing agreements with out-of-state licensing
agencies, but is not required to do so.
Source: ND Century Code Sec. 43-17-21 (2012).

Private Payers

Recently Passed Legislation (Now Effective) No reference found.

Requires insurers to provide coverage for services
delivered via telehealth. Payment of expenses may be
established through negotiations conducted between the
insurer and health services providers.
A policy is not required to provide coverage for health
services that are not medically necessary, subject to the
terms and conditions of the policy.
Source: ND Code Sec. 26.1-36-09.15.

Site/Transmission Fee

Under the Worker’s Compensation Act, the originating Reimbursement will be made to the originating site as a
sites may receive a facility fee, not to exceed $20. facility fee only in place of service office, inpatient
hospital, outpatient hospital, or skilled nursing
Source: ND Admin. Code 92-01-02-34. facility/nursing facility. There is no additional
reimbursement for equipment, technicians or other
technology or personnel utilized in the performance of
the telemedicine service.
Source: Medicaid Medical Policy. North Dakota Department of
Human Services: Policy Number NDMP-2012-0007. Telemedicine
Services. (Jan. 14, 2015) (Accessed Oct. 2017).

Miscellaneous

For all policies in the Public Employees Retirement
System that become effective after June 30, 2015 and
don’t extend passed June 30, 2017 to board shall
provide coverage for telehealth services the same as in-
person.
The public employees’ retirement system must prepare
and submit for introduction a bill to the 65th legislative
assembly to repeal the expiration date to the Act, and
apply telehealth coverage to all group and individual
insurance policies.
Source: ND House Bill 1038 (2015), ND Statute Sec. 54-52.1-04.13.

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